Determination of norcantharidin in mouse tissues by liquid chromatography coupled to tandem mass spectrometry and its tissue distribution study

The purpose of this study is to determine the concentrations of norcantharidin (CAS NO: 5442-12-6) in mouse tissues and investigate its tissue distribution after intragastric administration of disodium norcantharidate solution. A highly sensitive and specific liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed and validated, using ribavirin (CAS NO: 36791-04-5) as the internal standard (IS). Norcantharidin and IS were extracted from 0.3 mL tissue homogenates using protein precipitation with acetone under acid condition. The analyte was separated on a C18 reverse phase column and analyzed by MS/MS in the multiple reaction monitoring (MRM) mode using ESI with positive ionization, m/z 169→123 for norcantharidin and m/z 267→135 for IS. The developed method was validated over a linear range of concentrations 0.01~5 μg·mL - 1 in liver, lung, kidney, stomach, small intestine, uterus and testis, 0.005~0.5 μg·mL - 1 in heart, spleen and brain, the correlation coefficients (r2) were between 0.9918 and 0.9976. The tissue distribution study result was as follows: The AUC0-t of norcantharidin in tissues was in the order as follows: small intestine, stomach, uterus, kidney, testis, liver, lung, spleen, heart, brain.

Pharmacokinetic and bioequivalence studies of trospium chloride after a single-dose administration in healthy Chinese volunteers

The study aimed to compare and evaluate the bioequivalence of a new generic preparation of trospium chloride (CAS NO:10405-02-4) capsule (20 mg, test) and the available import tablet (20 mg , reference) for the requirement of state regulatory criteria in China. A randomized- sequence, 2-period crossover study was conducted in 20 healthy Chinese male volunteers in the fasted state. Blood samples were collected before and 1, 2, 3, 4, 5, 6, 7, 8, 12, 24, 36, 48, 60 h after administration of a single oral dose of 40 mg trospium chloride capsules or tablets, followed by a 7-day washout period. The concentration of trospium chloride was determined by a LC-MS/MS method. Drug And Statistical-Version 2.0 was used to calculate the pharmacokinetics parameters and assess bioequivalence of the two preparations. It was considered bioequivalent if the 90% CIs of the mean ratios (test: reference) for Cmax, AUC0-t and AUC0-∞ were within the range from 80% to 125%, respectively. The main pharmacokinetics parameters of test and reference were as follows: t1/2 was (15.11 ± 3.24) h and (16.00 ± 3.96) h; Tmax was (4.0 ± 1.2) h and (4.1 ± 0.9) h; Cmax was (3.76 ± 1.87) ng·mL - 1 and (3.70 ± 1.89) ng·mL - 1; AUC0-t was (33.51 ± 14.39) ng·mL - 1·h and (33.33 ± 14.88) ng·mL - 1·h, and the AUC0-∞ was (35.20 ± 14.88) ng·mL - 1·h and (35.16±15.17) ng·mL - 1·h. The ratios (test: reference) for Cmax, AUC0-t, and AUC0-∞ were 94.0%~111.7%, 96.4%~106.8%, and 96.1%~105.3%, respectively. No significant differences in pharmacokinetic parameters were found between preparations and periods (p>0.05). No obvious adverse events were monitored throughout the study based on clinical parameters and patient reports.

Beam-target double-spin asymmetry A{LT} in charged pion production from deep inelastic scattering on a transversely polarized {3}He target at 1.4<Q{2}<2.7 GeV{2}

We report the first measurement of the double-spin asymmetry A{LT} for charged pion electroproduction in semi-inclusive deep-inelastic electron scattering on a transversely polarized {3}He target. The kinematics focused on the valence quark region, 0.16<x<0.35 with 1.4<Q{2}<2.7  GeV{2}. The corresponding neutron A{LT} asymmetries were extracted from the measured {3}He asymmetries and proton over {3}He cross section ratios using the effective polarization approximation. These new data probe the transverse momentum dependent parton distribution function g{1T}{q} and therefore provide access to quark spin-orbit correlations. Our results indicate a positive azimuthal asymmetry for π{-} production on {3}He and the neutron, while our π{+} asymmetries are consistent with zero.

CMRI based 3D left ventricle motion analysis on patients with acute myocardial infarction

3D Quantitative measurement of left ventricle (LV) motion on patients with acute myocardial infarction has been recognized as essential for effective LV function diagnosis. This paper presents a method to quantify 3D LV motion obtained from conventional CINE MRI using image analysis based on mathematical modeling. Level set method is employed for segmentation, and a 3D LV geometry was reconstructed by co-registering different views of MRI images. A mathematical model of LV geometry was then constructed to quantitatively describe the LV wall inward motion. The results using real data show that the method is able to quantify the LV inward motion, and can clearly represent the changed motion pattern with the follow-up data. Furthermore, the LV motion analysis for 8 patients with acute myocardial infarction (MI) show that high inward motion occurs mainly in the basal region of LV while a negative relation is found between LV ejection fraction (EF) improvement after acute MI and solely basal region inward motion, which could be helpful for diagnosis and LV EF recovery prediction.

Precise measurement of deuteron tensor analyzing powers with BLAST

We report a precision measurement of the deuteron tensor analyzing powers T(20) and T(21) at the MIT-Bates Linear Accelerator Center. Data were collected simultaneously over a momentum transfer range Q=2.15-4.50 fm(-1) with the Bates Large Acceptance Spectrometer Toroid using a highly polarized deuterium internal gas target. The data are in excellent agreement with calculations in a framework of effective field theory. The deuteron charge monopole and quadrupole form factors G(C) and G(Q) were separated with improved precision, and the location of the first node of G(C) was confirmed at Q=4.19±0.05 fm(-1). The new data provide a strong constraint on theoretical models in a momentum transfer range covering the minimum of T(20) and the first node of G(C).

P4-20-04: Cytokine Synthesis by Activated Dendritic Cells in Relation to Disease Progression in Inflammatory Breast Cancer (IBC)

Background: Deficiencies in innate and adaptive immune responses by plasmacytoid dendritic cells (pDC) and myeloid DC (mDC) have been linked to poor clinical outcome in breast cancer (BC) (Treilleux, Clin Cancer Res, 2004, PMID 15569976). pDC produce IFN-a and pro-inflammatory cytokines that regulate innate and adaptive immunity in breast cancer. mDC present in blood and secondary lymphoid organs secrete IL-12 and induce inflammatory cytokine production by T cells. Therefore, we studied DC activity in the peripheral blood and assessed their function with clinical outcome in breast cancer patients.

Methods: We recruited 115 BC patients [25 with locally advanced non-IBC (LABC), 25 with IBC, 21 with metastatic breast cancer (MBC), and 44 with metastatic IBC (mIBC)] and 31 healthy donors (HD) for this study. Peripheral blood pDC and mDC were activated through toll-like receptor (TLR)-7 to assess IFN-α and IL-10 production whereas mDC were activated through TLR-8 to assess production of IL-12 and TNF-α by multi-parameter flow cytometry. Associations between cytokine production by TLR-activated pDC and mDC with progression free survival (PFS) and overall survival (OS) of patients were analyzed by Kaplan Meier Test.

Results: The median follow-up (FU) of 113 evaluable patients was 14.1 months with a median time to progression of 10.5 months; 54 patients had stable disease (SD) and 59 had progression of disease (PD). Metastasis, previous treatments, and IBC contributed to shorter PFS and OS. Compared to HD, BC patients had significantly fewer total DC (p=0.008), mDC (p=0.008), and pDC (p=0.003) per μL. In general, the number of TLR-7-activated pDC per μL that produced IFN-a(p=0.023) or IL-10 (p=0.027) and the number of TLR-8-activated mDC per μL that produced IL-12 (p&lt;0.001) or TNF-α (p=0,008) were significantly lower in BC patients than in HD. However, patients with DC that produced these cytokines above the median levels of HD had shorter PFS or OS. In IBC patients, higher numbers of TLR-8-activated mDC that produced TNF-α (p=0.025) or IL-12 (p=0.003) predicted shorter OS. In mIBC patients, a higher number of TLR-7-activated pDC producing IFN-α (p=0.024) or IL-10 (p=0.034) predicted shorter PFS.

Conclusion: BC patients had significantly fewer pDC and mDC in peripheral blood than HD. IBC patients with above average numbers of TLR-activated DC capable of producing proinflammatory cytokines had a significantly shorter PFS or OS. Disease progression in IBC is related to an increased number of activated dendritic cells producing inflammatory cytokines.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-20-04.

P1-02-07: Epithelial-Mesenchymal Transition Correlated with Serum Cytokine Profiling in Breast Cancer Patients

Background: Inflammation contributes to the increased invasiveness and poor prognosis in breast cancer (BC) patients. Specifically, the expression of the proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα) and interleukin-1 (IL-1) have all been linked to increased invasiveness and poor prognosis. Interestingly, the increased invasiveness was associated with an increase in the acquisition of markers of epithelial-mesenchymal transition (EMT). Therefore, we determined whether the levels of circulating proinflammatory cytokines (IL-1, IL-6, TNFα) and antiinflammatory cytokines (IL10) were correlated with the induction of EMT transcription factors (TFs), Snail1, Zeb1, Twist1, in breast cancer patients.

Materials and Methods: From two laboratory-based ongoing studies at the MD Anderson Cancer Center, 41 BC patients were assessed for EMT-TFs in circulating CD45-ve cells (EMT-CTCs) and for serum proinflammatory cytokines before starting any treatment. 32 of 41 patients assessed for EMT had metastatic BC. EMT-CTCs were detected by qRT-PCR for the EMT-TFs Snail1, Zeb1 and Twist1 (Mego 2011; PMID 21387303) and serum cytokines were measured by Luminex bead array assay (MILLIPLEX™ MAP Human Cytokine/Chemokine Panel). Cytokine serum concentrations were compared with the median cytokine levels of healthy donors (HD). We examined the association of serum cytokines above the median HD levels and the presence of EMT-CTCs by non-parametric Mann-Whitney test with a statistical significance for p&lt;.05.

Results: Of the 41 patients assessed for both serum cytokines and EMT-CTCs, 14 (34%) were positive for at least one EMT-TF, including 3 of 9 (33%) patients with no-metastatic BC and 11 of 32 (34%) patients with metastatic BC. We found that serum levels of IL1a, IL2, TGFα, and TNFβ in patients that were above the median levels of HD sera were higher in patients with EMT-CTCs in the blood (higher IL1a concentration in patients with over expression of Snail1, Zeb1, and Twist1; IL2 with Zeb1; TGFα with Snail1; TNFβ with Zeb1, and Twist1). Further, the higher ratio of proinflammatory/anti-inflammatory cytokines, was associated with the presence of at least one EMT-TF, e.g., IL8/IL10 (p=.005) and TNFα/IL10 (p=.037). Discussion: Patients with proinflammatory cytokine (IL1a, IL2, TGFα, and TNFβ) levels above the median levels of HD or who had a predominantly proinflammatory cytokine profile were more likely to have at least one EMT-TF in their blood. These data are consistent with the hypothesis that proinflammatory cytokines promote EMT, which may be involved in tumor aggressiveness and disease progression.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-02-07.

P1-04-02: In Vitro Qualification and Quantification of Murine Mammary Stem/Progenitor Cells

Increasing evidence suggest that tumors with a cell origin of more basal or stem-like sources are often highly metastatic and associated with poor prognosis. Identification of the cell of origin thus has important implications for development of new preventive and therapeutic approaches. To identifying the cells of origin of various breast cancers, understanding the normal cellular hierarchy within the breast tissue is an important prerequisite. However, current understanding of normal mammary stem/progenitor cell is limited due to the lack of a robust in vitro assay. The newly developed cell surface markers (CD24+CD49fhi) can only be used for low percent of enrichment. The only gold standard assay for functional evaluation of stem cell property is the in vivo transplantation of cleared mammary fat pad assay, yet this assay is expensive, time consuming, and requires highly trained skills, and thus cannot be used routinely for experiments. The goal of our study is thus to develop a robust in vitro assay to qualify and quantify murine mammary stem/progenitor cells. Our rationale lies on our recent findings of in vitro study of different fractions of murine stem/progenitor cells. When we use isolated primary epithelial cells for in vitro mammosphere formation, we found that stem cell enriched fraction and progenitor cell enriched fraction both formed very small mammospheres (≤ 50 μm) and these spheres appear to be of clonal origin (one cell gives rise to one sphere). When we plated these small spheres into 3D extracellular matrix for colony formation, however, they gave rise to two distinct structures: stem-enriched fraction generated predominately solid structure while progenitor-enriched fraction is dominated by hollow structures. Previous studies have linked the solid structure to the basal/myoepithelial lineage and the hollow structure to the luminal lineage. We thus suspected that the small mammospheres derived from the stem or progenitor enriched fractions could be originated from single stem or progenitor cell, and the number of spheres could indicate the number of original stem/progenitor cells within these enriched fractions. Subsequent in vivo transplantation with single sphere or single solid structure cultured in 3D extracellular matrix derived from green fluorescent protein transgenic mice proved that single sphere or 3D solid structure can repopulate the gland-free mammary fat pad. To conclude, the in vitro mammosphere formation in combination with subsequent differentiation in 3D extracellular matrix can be used as a robust in vitro assay for qualification and quantification of murine mammary stem/progenitor cells. This in vitro assay will greatly facilitate our understanding of genes regulate stem cell self-renewal, proliferation, differentiation as well as mechanisms keeping them at quiescent state within the niche.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-04-02.

P3-03-02: Higher Expression Levels of Circulating miR-21, miR-19a and miR-10b Are Associated with High Risk Features in Breast Cancer

Background: MicroRNAs (miRs) have oncogenic and tumor-suppressor functions. MiR-21, miR-19a and miR-10b are overexpressed in breast cancer and regulate tumor cell migration, invasion and angiogenesis. We assessed the levels of miR-21, -19a, and -10b in sera of breast cancer patients and their association with the stage, histological type, hormonal receptor (HR) status and HER2 amplification in the primary tumor. Since circulating tumor cells (CTC) detected by CellSearch® are an independent and strong predictor of overall survival in metastatic breast cancer (MBC), we assessed the relationship between circulating miRs and CTCs.

Methods: The study consisted of 30 healthy donors (HD) and 95 breast cancer (BC) patients. Patients’ sera were collected before starting a new line of treatment. Total RNA was isolated, reverse transcribed to cDNA and then subjected to qRT-PCR for the detection of miR-21, -19a, -10b and -192 using the TaqMan MicroRNA Assay (Applied Biosystems, Foster City, CA). Mir-192 was used to normalize the expression levels of the other miRs. Fold-changes in expression of miRs were calculated using the 2−DCt method, where DCt= mean CTtarget-miRNA -mean CTmiR-192. CTCs were enumerated using CellSearch™ (Veridex LLC, Warren, NJ). Mann-Whitney U test was used to determine differences in serum miR expression levels between patients and HD.

Results: Of the 95 BC patients, 39 were non-MBC and 56 MBC. Patients grouped according to the receptor expression by immunohistochemical staining consisted of 27 HR+HER2−, 30 HR+HER2+, 20 HRHER2+, and 18 HRHER2− triple negative BC (TNBC). MiR-21 and miR-19a were higher in non-MBC patients than in HD (p=.001, p&lt;.001, respectively). MiR-21, miR-19a and miR-10b levels were higher in metastatic patients than in HD (p&lt;.001, p&lt;.001, p=.038, respectively). MBC patients had a higher median level of miR-21 than that of non-MBC patients (p=.02). Patients with (HR+HER2+, HR−HER2+, TNBC) had significantly higher median levels of both miR-21 (p=.018; p=.009; p=.045) and miR-10b (p=.011; p=.014; p=.03) compared with HR+HER2− BC. HER2+ patients had higher median levels of both miR-21 and miR-10b than those of HER2− BC (p=.033; p=.01) and HD (p&lt;.001; p=.009). Further, median miR-19a expression was higher in IBC patients than in non-IBC patients (p=.025). Finally, patients with &lt;5 CTCs had a higher median expression level of miR-10b than that of patients with ≥5 CTCs (p=.042).

Discussion: High expression levels of miR-21, miR-19a and miR-10b in sera are observed in breast cancer patients, especially with advanced disease. HER2+ BC patients had higher serum levels of miR-21 and miR-10b than HER2−. IBC patients had a higher serum level of miR-19a than non-IBC patients. Moreover, patients with &lt;5 CTCs had high serum levels of miR-10b that can be induced by Twist1 during the epithelial-mesenchymal transition (EMT) and, in part, explain the inability of CellSearch® to detect CTCs undergoing EMT.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-03-02.

P4-20-03: T-Cell Cytokine Production Related to Progression of Breast Cancer Patients

Background: Impaired immunosurveillance and immune dysregulation contribute to the pathogenesis and progression of breast cancer (BC). Upon activation, T cells synthesize inflammatory cytokines such as TNF-α that can promote or inhibit tumor growth. We therefore investigated T-cell cytokine syntheses as a predictor of disease progression.

Methods: We recruited 115 BC patients [25 with locally advanced breast cancer (LABC), 21 with metastatic breast cancer (MBC), 25 with non-metastatic inflammatory breast cancer (IBC), and 44 with metastatic IBC (mIBC)] and 31 healthy donors (HD) for this ongoing study. The tumor phenotype consisted of 69 hormone receptor (HR) positive (including 26 patients with HER2 positive disease), 16 HR negative but HER2+, 30 triple negative BC (TNBC). To evaluate T cell function, peripheral blood mononuclear cells from patients and HD were stimulated overnight with immobilized anti-CD3 and soluble anti-CD28 antibodies and assessed for the percentage of T cells that synthesized cytokines by multi-parameter flow cytometry. The associations of T cell cytokine production profile with patient progression free survival (PFS) were analyzed by Kaplan Meier Test.

Results: The median follow-up (FU) of 113 evaluable patients was 14.1 months with a median time to relapse of 10.5 months; 54 patients had stable disease (SD) and 59 patients had progression of disease (PD). In the entire cohort, on univariate analysis, metastasis, IBC, stage, and previous treatment predicted for worse PFS (p&lt; 0.05). In non-metastatic patients (LABC+IBC), absolute count of anti-CD3 activated CD8+ T cells producing IL-17 was significantly higher in the SD patients compared with patient with PD (p=0.038), but it did not predict PFS (p=0.073). Similarly in metastatic patients, anti-CD3 activated CD4+ T cells producing TNF-α were significantly higher in patients with SD (p=0.025) and was predictive of longer PFS (p=0.033). Considering all patients with IBC (IBC + mIBC), although patients with PD had significantly fewer (percent and absolute number) anti-CD3 activated T cells capable of producing cytokines, this immune impairment was mostly related to metastasis and previous treatment. However, the percentage of anti-CD3 activated CD8+ T cells producing TNF-α was an independent positive prognostic indicator of PFS (p=0.002).

Conclusion: Higher than average cytokine syntheses by anti-CD3 activated T cells are significantly associated with longer PFS. These data are consistent with the hypothesis that an adaptive immune response can control disease progression.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-20-03.

Heading date gene, dth3 controlled late flowering in O. Glaberrima Steud. by down-regulating Ehd1

Heading date in rice is an important agronomic trait controlled by several genes. In this study, flowering time of variety Dianjingyou 1 (DJY1) was earlier than a near-isogenic line (named NIL) carried chromosome segment from African rice on chromosome 3S, when grown in both long-day (LD) and short-day (SD) conditions. By analyzing a large F2 population from NIL × DJY1, the locus DTH3 (QTL for days to heading on chromosome 3) controlling early heading date in DJY1 was fine mapped to a 64-kb segment which contained only one annotated gene, a MIKC-type MADS-box protein. We detected a 6-bp deletion and a single base substitution in the C-domain by sequencing DTH3 in DJY1 compared with dth3 in NIL, and overexpression of DTH3 caused early flowering in callus. Quantitative real-time PCR revealed that the transcript level of dth3 in NIL was lower than that DTH3 in DJY1 in both LD and SD conditions. The Early heading date 1 (Ehd1) which promotes the RFT1, was up-regulated by DTH3 in both LD and SD conditions. Based on Indel and dCAPs marker analysis, the dth3 allele was only present in African rice accessions. A phylogenetic analysis based on microsatellite genotyping suggested that African rice had a close genetic relationship to O. rufipogon and O. latifolia, and was similar to japonica cultivars. DTH3 affected flowering time and had no significant effect on the main agronomic traits.

Correlation of brain natriuretic peptide and microalbuminuria in patients with heart failure

OBJECTIVE

To evaluate the changes of plasma levels of N-terminal pro-brain natriuretic pepide (NT-proBNP) and microalbuminuria (MAU) in patients with heart failure and the correlation between them.

METHODS

Ninety-one patients with heart failure were divided into different groups according to different stages of heart failure. Plasma levels of NT-proBNP were measured by microsome enzyme immunoassay (MEIA). Plasma levels of MAU were determined by immune scattering turbidimetry (ICTM). Simultaneously, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were measured by Doppler echocardiography for all patients. The correlation of NT-proBNP and MAU was evaluated at different stages of heart failure.

RESULTS

The plasma levels of NT-proBNP and MAU increased with the severity of heart failure. There was a high correlation between NT-proBNP and MAU (r = 0.885, p < 0.001).

CONCLUSION

Both NT-proBNP and MAU levels were closely associated with the severity of heart failure.

Single spin asymmetries in charged pion production from semi-inclusive deep inelastic scattering on a transversely polarized 3He Target at Q2 = 1.4-2.7 GeV2

We report the first measurement of target single spin asymmetries in the semi-inclusive (3)He(e,e'π(±))X reaction on a transversely polarized target. The experiment, conducted at Jefferson Lab using a 5.9 GeV electron beam, covers a range of 0.16 < x < 0.35 with 1.4 < Q(2) < 2.7 GeV(2). The Collins and Sivers moments were extracted from the azimuthal angular dependence of the measured asymmetries. The π(±) Collins moments for (3)He are consistent with zero, except for the π(+) moment at x = 0.35, which deviates from zero by 2.3σ. While the π(-) Sivers moments are consistent with zero, the π(+) Sivers moments favor negative values. The neutron results were extracted using the nucleon effective polarization and measured cross section ratios of proton to (3)He, and are largely consistent with the predictions of phenomenological fits and quark model calculations.

A photo-multiplier tube-based hybrid MRI and frequency domain fluorescence tomography system for small animal imaging

Fluorescence tomography (FT) is a promising molecular imaging technique that can spatially resolve both fluorophore concentration and lifetime parameters. However, recovered fluorophore parameters highly depend on the size and depth of the object due to the ill-posedness of the FT inverse problem. Structural a priori information from another high spatial resolution imaging modality has been demonstrated to significantly improve FT reconstruction accuracy. In this study, we have constructed a combined magnetic resonance imaging (MRI) and FT system for small animal imaging. A photo-multiplier tube is used as the detector to acquire frequency domain FT measurements. This is the first MR-compatible time-resolved FT system that can reconstruct both fluorescence concentration and lifetime maps simultaneously. The performance of the hybrid system is evaluated with phantom studies. Two different fluorophores, indocyanine green and 3-3' diethylthiatricarbocyanine iodide, which have similar excitation and emission spectra but different lifetimes, are utilized. The fluorescence concentration and lifetime maps are both reconstructed with and without the structural a priori information obtained from MRI for comparison. We show that the hybrid system can accurately recover both fluorescence intensity and lifetime within 10% error for two 4.2 mm-diameter cylindrical objects embedded in a 38 mm-diameter cylindrical phantom when MRI structural a priori information is utilized.

Relationship between pulse wave velocity and carotid atherosclerosis in geriatric people

OBJECTIVE

To investigate the relationship between the pulse wave velocity (PWV) and angiographic carotid atherosclerosis in elderly patients.

METHOD

103 consecutive elderly patients were divided into two groups according to the results of cerebral angiography: carotid atherosclerosis group and normal carotid angiogram group. Basic clinical information was required by a standardized questionnaire. Carotid-femoral PWV (cfPWV) as a marker of Stiffness of artery was measured, Carotid intima media thickness (IMT) and carotid stenosis degree in angiography was evaluated. Independent-sample t test was used to evaluate the difference in cfPWV between the two groups, Bivariate associations between cfPWV and an index of extracoronary atherosclerosis (IMT and severity of stenosis) was performed.

RESULT

Among 103 subjects, 55 with carotid atherosclerosis and 48 with a normal carotid angiogram, a significant difference between the two groups in IMT and PWV was found (P<0.05), and the cfPWV was significantly correlated with IMT (r = 0.3222, P = 0.0315), but not severity of carotid stenosis (r = 0.1573, P = 0.3137).

CONCLUSION

cfPWV showed a positive correlation to carotid IMT, and maybe is a potentially useful adjunctive atherosclerotic risk marker to Identify of early carotid atherosclerosis.

Interleukin-21 is upregulated in hepatitis B-related acute-on-chronic liver failure and associated with severity of liver disease

The immune mechanism(s) that lead to hepatitis B-related acute-on-chronic liver failure (HB-ACLF) are poorly understood. Interleukin-21 is a newly discovered cytokine that is involved in autoimmune and inflammatory diseases. Its potential role in HB-ACLF remains unknown. The serum levels of 12 immune cytokines measured by cytometric bead arrays and the frequency of IL-21-secreting CD4+ T cells in peripheral blood mononuclear cells (PBMC) measured by intracellular cytokine staining were compared in moderate chronic hepatitis B (M-CHB, n = 20), severe chronic hepatitis B (S-CHB, n = 20), HB-ACLF (n = 39) and healthy controls (n = 10). PBMC from M-CHB patients or healthy subjects were stimulated with rhIL-21 in vitro, and cytokines in supernatants were measured by FlowCytomix. The frequencies of IL-21-secreting CD4+ T cells were higher in HB-ACLF (both P < 0.001) and S-CHB (P = 0.002 and 0.001) as compared to M-CHB patients and controls. Serum IL-21 levels were highest (P < 0.001) in HB-ACLF and positively associated with high MELD score (P = 0.001) and mortality (P = 0.038). Recovery from HB-ACLF was associated with reduced serum IL-21 levels (P = 0.003) and lower CD4+ IL-21(+) T-cell frequency (P = 0.006). The secretions of IL-1β (P < 0.001), IL-6 (P < 0.001), IL-10 (P < 0.001), IFN-γ (P = 0.001) and TNF-α (P = 0.042) from PBMC were significantly increased with rhIL-21 stimulation. In summary, IL-21 has a causal role in the development of severe liver inflammation, which is upregulated in HB-ACLF and associated with severity of liver disease.